Medicare Part D Plans are insurance cards for the pharmacy that give you lower cost medications. Basically instead of paying the full cost for your prescriptions, you will pay only the co-pays required by the plan.
For a very long time there was no retail drug coverage for Medicare beneficiaries. Part D is the solution.
While enrollment into Medicare Part D is voluntary, there are life-time penalties if you avoid or delay your enrollment.
Today there are over 50 million Medicare beneficiaries enrolled in Part D coverage.
What Companies Offer Part D Plans
Some of the biggest brand name companies in the health insurance industry offer Medicare Part D Plans. This includes name brands like Humana, Aetna, Blue Cross and Blue Shield, United Healthcare Medicare Solutions and more. There are also some companies you may not have heard of before you were eligible for Medicare, such as Silverscript. Silverscript is now owned by Aetna.
Choosing a Part D plan is a lot easier said than done. Drug plans are not all created equal like Medigap plans and often there are just too many choices. Many States have more than 30 options.
The best way to find the right plan is to have a broker like Simple Senior Care assist you. We can use Medicare’s Drug Plan Finder tool to analyze the plans offered in your state and help you enroll in whichever plans will give you the lowest annual out-of-pocket spending.
Most of the time, your Part D plan will be provided by a different insurance company than your supplemental insurance. This is completely normal and usually makes things easier so Insurance cards aren't mixed up at the doctor and at the pharmacy.
How and When to Enroll in Part D
In order to avoid life-time penalties you need to enroll in Medicare Part D during your Initial Enrollment period when you turn 65 unless you have other creditable drug coverage, like employer coverage or VA benefits.
Is it Mandatory to Enroll in a Part D Plan?
No. Part D is voluntary, which means each individual can decide whether or not to enroll. However, you should think about not just the medications you are taking now but also those that you may need in the future. Keep in mind that some cancer medications these days can cost thousands of dollars, and no one has a crystal ball to see into their future health.
What Happens If I Don’t Enroll in Part D When I am First Eligible?
If you fail to enroll in Part D during your Medicare Initial Enrollment Period, you will have to wait for a future Annual Election Period to enroll, which means you could be without coverage for months after a diagnosis of an illness before you can get into a plan. You will also be assessed a penalty for the rest of your life when you do enroll. The only exception to this is if you didn’t enroll because you had other creditable drug coverage, like employer coverage or VA benefits.
The Medicare Part D Late Enrollment Penalty
If do not enroll correctly into Part D during your initial enrollment period it may result in a life-time penalty. As mentioned before, the penalty will be waived if you have had creditable coverage for prescription drugs, such as through an employer group health plan or VA benefits. If not, then the penalty depends on how long you waited to enroll in a plan. We've mentioned that while Medicare Part D is voluntary, you should seriously consider enrolling in Part D to avoid any penalties.
The cost of the late enrollment penalty depends on how long you went without Part D or creditable prescription drug coverage.
Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($33.19 in 2019 and $32.74 in 2020) times the number of full, uncovered months you didn't have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.
The national base beneficiary premium may increase each year, so your penalty amount may also increase each year.
Most importantly, if you miss your opportunity, you can't buy a drug plan without a special circumstance until the next AEP.
Just imagine if you develop a serious health condition in March and you require expensive medication for it. You would be stuck paying full retail cost until the next AEP. This means you no coverage until January 1st.
Get Assistance Enrolling into Part D
We provide FREE assistance to our clients upon enrollment and each year as an exclusive service to our clients during AEP.